Expandable proximal reamer

ABSTRACT

A reamer for reaming a portion of a long bone cavity for use in implanting a joint prosthesis. The reamer is used in cooperation with a portion of an orthopaedic implant component and includes an expandable body that is adapted to adjust between a plurality of diameters. A plurality of cutting edges are also included and extend outwardly from the body, the edges adapted for cooperation with bone, and the cutting edges expanding as the expandable body expands.

TECHNICAL FIELD OF THE INVENTION

The present invention relates generally to the field of orthopaedics,and more particularly, to an implant for use in arthroplasty.

BACKGROUND OF THE INVENTION

Patients who suffer from the pain and immobility caused byosteoarthritis and rheumatoid arthritis have an option of jointreplacement surgery. Joint replacement surgery is quite common andenables many individuals to function properly when it would not beotherwise possible to do so. Artificial joints are usually comprised ofmetal, ceramic and/or plastic components that are fixed to existingbone.

Such joint replacement surgery is otherwise known as joint arthroplasty.Joint arthroplasty is a well-known surgical procedure by which adiseased and/or damaged joint is replaced with a prosthetic joint. In atypical total joint arthroplasty, the ends or distal portions of thebones adjacent to the joint are resected or a portion of the distal partof the bone is removed and the artificial joint is secured thereto.

There are known to exist many designs and methods for manufacturingimplantable articles, such as bone prostheses. Such bone prosthesesinclude components of artificial joints such as elbows, hips, knees andshoulders.

Currently in total hip arthroplasty, a major critical concern is theinstability of the joint. Instability is associated with dislocation.Dislocation is particularly a problem in total hip arthroplasty.

Factors related to dislocation include surgical technique, implantdesign, implant positioning and patient related factors. In total hiparthroplasty, implant systems address this concern by offering a seriesof products with a range of lateral offsets, neck offsets, head offsetsand leg lengths. The combination of these four factors affects thelaxity of the soft tissue. By optimizing the biomechanics, the surgeoncan provide a patient a stable hip that is more resistant todislocation.

In order to accommodate the range of patient arthropathy metrics, a widerange of hip implant geometries are currently manufactured by DePuyOrthopaedics, Inc., the assignee of the current application, and byother companies. In particular, the S-ROM® total hip systems offered byDePuy Orthopaedics, Inc. may include up to six neck offsets per stemdiameter, six head lengths and one leg length adjustment. Thecombination of all these biomechanic options is rather complex.

Anteversion of a total hip system is closely linked to the stability ofthe joint. Improper anteversion can lead to dislocation and patientdissatisfaction. Anteversion control is important in all hip stems.However, it is a more challenging issue with the advent of stems withadditional modularity.

The prior art has provided for some addressing of the anteversionproblem. For example, the current S-ROM® stems have laser markings onthe medial stem and the proximal sleeve. This marking enables thesurgeon to measure relative alignment between these components. Sincethe sleeve has infinite anteversion, it is not necessarily orientedrelative to a bony landmark that can be used to define anteversion. Infact, the current sleeves are sometimes oriented with the spout pointingdirectly laterally into the remaining available bone.

When a primary or index total joint arthroplasty fails, a revisionprocedure is performed in which the index devices (some or all) areremoved. Quite often the remaining bone is significantly compromisedcompared to a primary hip procedure. Significant bone loss is observed,often with a lack of bone landmarks typically used for alignment.

In a common step in the surgical procedure known as total hiparthroplasty, a trial or substitute stem is first implanted into thepatient. The trial is utilized to verify the selected size and shape ofthe implant in situ on the patient and the patient is subjected to whatis known as a trial reduction. This trial reduction represents movingthe joint, including the trial implant through selected typical motionsfor that joint. Current hip instruments provide a series of trials ofdifferent sizes to help the surgeon assess the fit and position of theimplant. Trials, which are also known as provisionals, allow the surgeonto perform a trial reduction to assess the suitability of the implantand the implant's stability prior to final implant selection. In orderto reduce inventory costs and complexity, many trialing systems aremodular. For example, in the Excel™ Instrument System, a product ofDePuy Orthopaedics, Inc., there is a series of broaches and a series ofneck trials that can be mixed and matched to represent the full range ofimplants. There is a single fixed relationship between a broach and aneck trial, because these trials represent a system of monolithic stemimplants.

Likewise, in the current S-ROM® instrument systems provided by DePuyOrthopaedics, Inc., there are neck trials, proximal body trials, distalstem trials, head trials and sleeve trials. By combining all of thesecomponents, the implant is represented. Since the S-ROM® stem is modularand includes a stem and a sleeve, the angular relationship or relativeanteversion between the neck and the sleeve is independent andrepresented by teeth mating between the neck and the proximal bodytrial. The proximal body trial has fixed transverse bolts that are keyedto the sleeve in the trialing for straight, primary stems. The long stemtrials do not have the transverse bolts and are thus not rotationallystable during trial reduction and therefore are not always used by thesurgeon.

With the introduction of additional implant modularity, the need forindependent positioning of the distal stem, proximal body and any sleevethat comprise the implants is required. Currently, modular stems for onereplacement may come with up to thirty four different sleeve geometries,requiring up to seven different reamer attachments and correspondingpilot shafts to prepare the cone region of the sleeve.

While the prior art has attempted to reduce the steps in surgicaltechniques and improve the ability to precisely remove bone to preparethe bone for receiving a proximal component, the need remains for asystem and apparatus to reduce the number of components required toperform hip arthoplasty.

The present invention is directed to alleviate at least some of theproblems with the prior art.

SUMMARY OF THE INVENTION

According to one embodiment of the present invention, a reamer forreaming a portion of a long bone cavity for use in implanting a jointprosthesis is provided. The reamer is for cooperation with a portion ofan orthopaedic implant component and includes an expandable body that isadapted to adjust between a plurality of diameters. A plurality ofcutting edges extending outwardly from the body is also included. Theedges are adapted for cooperation with bone, such that the cutting edgesexpand as the expandable body expands.

According to another embodiment of the present invention, a method forreaming a portion of a long bone cavity for use in implanting a jointprosthesis is provided. The reamer is used in cooperation with a portionof an orthopaedic implant component. The method includes reaming adistal portion of the long bone using a distal reamer as well as reaminga proximal portion of the long bone using a proximal reamer. At leastone of the distal reamer and proximal reamer is an expandable reamer,such that one of the distal reamer and proximal reamer includes anexpandable body adapted to adjust between a plurality of diameters.

According to yet another embodiment of the present invention, a kit forreaming a portion of a long bone cavity for use in implanting a jointprosthesis is provided. The reamers are used in cooperation withportions of an orthopaedic implant component. The kit includes a distalreamer for reaming a distal portion of the long bone, a proximal reamerfor reaming a proximal portion of the long bone, and a pilot shaft forinsertion into a reamed distal portion and attachment to the proximalreamer during the reaming of the proximal portion. At least one of thedistal reamer, proximal reamer, and pilot shaft is expandable, such thatone of the distal reamer, proximal reamer, and pilot shaft includes anexpandable body adapted to adjust between a plurality of diameters.

BRIEF DESCRIPTION OF THE DRAWINGS

For a more complete understanding of the present invention and theadvantages thereof, reference is now made to the following descriptiontaken in connection with the accompanying drawings, in which:

FIG. 1 is a plan view of a distal reamer in position in a long bone forpreparing a bone canal for receiving a long bone prosthetic stem;

FIG. 2 is a plan view of an expandable distal reamer according to oneembodiment of the present invention;

FIG. 2 a is a plan view of the expandable distal reamer of FIG. 2 in anexpanded position, including a view of the internal components of thereamer;

FIG. 3 is a plan view of a proximal reamer in position in a long bonefor preparing a bone canal for receiving a long bone prosthetic stem;

FIG. 4 is a plan view of an expandable proximal reamer according to oneembodiment of the present invention;

FIG. 4 a is a plan view of the expandable proximal reamer of FIG. 4 inan expanded position, including a view of the internal components of thereamer;

FIG. 5 is a plan view of an expandable pilot shaft according to anotherembodiment of the present invention.

FIG. 5 a is a plan view of the expandable pilot shaft of FIG. 5,including a view of the internal components of the shaft.

FIG. 6 is a plan view of an expandable proximal reamer according toanother embodiment of the present invention.

FIG. 7 is a plan view of an expandable proximal reamer according to yetanother embodiment of the present invention.

FIG. 7 a is a plan view of the expandable proximal reamer of FIG. 7 inan expanded state.

FIG. 8 is a flow chart illustrating a method of using an expandablereamer according to one embodiment of the present invention.

DETAILED DESCRIPTION OF THE INVENTION

Embodiments of the present invention and the advantages thereof are bestunderstood by referring to the following descriptions and drawings,wherein like numerals are used for like and corresponding parts of thedrawings.

Referring now to FIG. 1 a long bone or femur 2 for use with the presentinvention is shown. The femur 2 includes an intermedullary canal 4 intowhich the prosthesis of the present invention may be inserted. The femur2 is resected along resection line 6 by, for example, a power tool, forexample, a saw. The resecting of the long bone or femur 2 exposes theintermedullary canal 4 of femur 2. A distal or cylindrical reamer 8 thatmay be a standard commercially available reamer is positioned in theintermedullary canal 4 of the long bone 2 to form cavity 10 forreceiving an orthopedic joint implant. The distal reamer 8 includes aplurality of longitudinally extending channels, or flutes 12 which areused to remove bone and other biological matter from the intermedullarycanal 4 to form the cavity 10. The distal reamer 8 may be rotated by useof a connector 14 positioned on the distal reamer 8. The connector 14may be any standard connector for example a Hudson or an A-O connector.The connector 14 is used to connect to a power tool 15 for rotating thedistal reamer 8. The power tool 15 may be any standard power tool. Itshould be appreciated that the distal reamer 8 may be rotated throughthe use of the connector 14 by a hand tool for example a “T” shapedhandle.

The diameter “D” of the distal reamer 8 is determined by the size of thedistal stem (not shown) that is to be implanted into the femur 2.Because of variances in human anatomy, there are numerous sizes ofdistal stems that can be implanted. Therefore, there are numerous sizesof reamers 8 that can also be used. The large number of reamers 8 canincrease production and manufacturing costs, as well as create problemsduring the surgery should the doctor select the wrong size distal reamer8 to be used.

Turning now to FIG. 2, an embodiment of an expandable distal reamer 8 ais shown. Because the distal reamer 8 a is expandable, the diameterD_(a) of the distal reamer 8 a is variable, unlike the fixed diametersof the prior art distal reamers.

As shown in FIG. 2, the expandable distal reamer 8 a includes a proximalportion 16 and a distal cutting portion 17. The proximal portion 16includes at least two gears 18, 20 that are in contact with each othersuch that when the gear 18 is rotated, the gear 20 also rotates. Similarto the distal reamer 8 of FIG. 1, the expandable distal reamer 8 aincludes flutes 12 a. The flutes 12 a expand outwardly from the reamer 8a when the gears 18, 20 are activated. The reamer 8 a also includes aplurality of slits, or cuts, 22 a, 22 b around its circumference. Suchslits 22 a, 22 b allow the diameter D_(a) of the expandable distalreamer 8 a to enlarge when the gears 18, 20 are rotated.

The gear 18 may be activated by inserting a chuck (not shown) into ahole 24 of the proximal portion 16 and then rotating the chuck.Alternatively, a gauge 25 (FIG. 2 a) may be inserted into the hole 24until it engages the gear 18 and rotated a desired amount. The gauge 25may include markers 27 (FIG. 2 a) to allow the user to know when to stoprotating the gauge. Any other known method for activating a gear mayalso be utilized.

Once the gears 18, 20 are activated, the gear 20 forces a cone 26 downthrough the proximal portion 16 into the distal cutting portion 17. Asthe cone 26 moves downwardly, the cone's increasing diameter forces thedistal cutting portion 17 to become enlarged. As stated above, thereamer 8 a includes slits 22 a, 22 b. These slits 22 a, 22 b allow thedistal portion 17 to expand as the cone 26 pushes further into thedistal portion 17. Therefore, the diameter D_(a) of the reamer 8 a alsoincreases.

In FIG. 2 a, the gauge 25 is shown inserted into the top of theexpandable distal reamer 8 a and the distal reamer 8 a is shown in anexpanded position, having a radius D_(b). When the gauge 25 is inserted,it engages the gear 18. The gauge 25 may include markings 27 thatcorrelate to the size of the diameter D_(a) of the expandable distalreamer 8 a. In other words, if the surgeon or other healthcareprofessional rotates the gauge 25 a particular amount, the marking 27indicates that the rotation correlates to a particular diameter D_(a) ofthe expandable distal reamer 8 a. Furthermore, as the gauge 25 isrotated, the slits 22 a, 22 b enlarge as shown in FIG. 2 a, creating thelarger diameter D_(b).

As shown in FIGS. 2 and 2 a, the diameter D_(a) of the expandable distalreamer 8 a may be enlarged through mechanical means such as gears 18,20. However, other devices, such as pneumatic or hydraulic mechanismscould also be used to adjust the diameter D_(a) of the expandable distalreamer 8 a. In addition, other mechanical devices, such as cross-barsand/or levers could be used to increase the diameter D_(a) of theexpandable distal reamer 8 a.

After the distal region of the femur 2 is reamed, the proximal portionmust then be reamed. As shown in FIG. 3, a conical or proximal reamer 30is used to form cavity 10 for receiving an orthopedic joint implant. Theproximal reamer 30 includes a plurality of longitudinally extendingchannels or flutes 32 which are used to remove bone and other biologicalmatter from the femur 2 to form a cavity 33 having a cone-shape, with adiameter varying between a diameter d₁ to d₂, which is the same shapeand diameter range of the cone-shaped proximal reamer 30. The proximalreamer 30 may be rotated by use of a connector 34 positioned on theproximal reamer 30. The connector 34 may be any standard connector forexample a Hudson or an A-O connector. The connector 34 is used toconnect to a power tool 35 for rotating the proximal reamer 30. Thepower tool 35 may be any standard power tool. It should be appreciatedthat the proximal reamer 30 may be rotated through the use of theconnector 34 by a hand tool for example a “T” shaped handle. Theproximal reamer 30 is coupled to a pilot shaft 36 that fits into thereamed cavity 10. The pilot shaft 36 ensures that the proximal reamer 30goes into the canal and reams straight.

Turning now to FIG. 4, an expandable proximal reamer 30 a according toone embodiment of the present invention is illustrated. Because theproximal reamer 30 a is expandable, the diameters d_(a1)-d_(a2) of theproximal reamer 30 a are variable, unlike the fixed diameters of theprior art proximal reamers.

Similar to the distal reamer 8 a shown in FIGS. 2 and 2 a above, theproximal reamer includes a proximal portion 37 and a distal cuttingportion 38. The proximal portion 37 includes at least two gears 39, 40that are in contact with each other such that when the gear 39 isrotated, the gear 40 also rotates. Similar to the proximal reamer 30 ofFIG. 3, the expandable proximal reamer 30 a includes flutes 32 a. Theflutes 32 a expand outwardly from the reamer 30 a when the gears 39, 40are activated. The reamer 30 a also includes a plurality of slits, orcuts, 42 a, 42 b, around its circumference. Such slits 42 a, 42 b, allowthe diameters d_(a1) and d_(a2) of the expandable proximal reamer 30 ato enlarge when the gears 39, 40 are rotated.

The gear 18 may be activated by inserting a chuck (not shown) into ahole 43 of the proximal portion 16 and then rotating the chuck.Alternatively, a gauge 44 (FIG. 4 a) may be inserted into the hole 43until it engages the gear 39 and rotated a desired amount. The gauge 44may include markers 46 (FIG. 4 a) to allow the user to know when to stoprotating the gauge. Any other known method for activating a gear mayalso be utilized.

Once the gears 39, 40 are activated, the gear 40 forces a cone 48 downthrough the proximal portion 37 into the distal cutting portion 38. Asthe cone 48 moves downwardly, the cone's increasing diameter forces thedistal cutting portion 38 to become enlarged. As stated above, thereamer 30 a includes slits 42 a, 42 b. These slits 42 a, 42 b allow thedistal portion 38 to expand as the cone 48 pushes further into thedistal portion 38. Therefore, the diameters d_(1a) and d_(1b) of theproximal reamer 30 a also increase.

In FIG. 4 a, the gauge 44 is shown inserted into the top of theexpandable proximal reamer 30 a and the reamer is shown in an expandedposition having diameters d_(b1) and d_(b2) that are greater than thediameters d_(a1) and d₃ 2. The gauge 44 may include markings 46 thatcorrelate to the size of the diameters d_(a1) and d_(a2) of theexpandable proximal reamer 30 a. In other words, if the surgeon or otherhealthcare professional rotates the gauge 44 a particular amount, themarking 46 indicates that the rotation correlates to particulardiameters d_(a1) and d_(a2) of the expandable proximal reamer 30 a.Furthermore, as the gauge 44 is rotated, the slits 42 a, 42 b enlarge asshown in FIG. 4 a, creating the larger diameters d_(b1) and d_(b2). Inthis embodiment, because of the conical shape of the reamer 30 a, as thegears 39, 40 are rotated, the diameter d_(a1) increases more relative tothe diameter d_(a2). In other words, proximal portion 37 is expandedmore relative to the distal portion 38.

As shown in FIGS. 4 and 4 a, the diameters d_(a1) and d_(a2) of theexpandable proximal reamer 30 a may be enlarged through mechanical meanssuch as gears 39, 40. However, other devices, such as pneumatic orhydraulic mechanisms could also be used to adjust the diameters d_(a1)and d_(a2) of the expandable proximal reamer 30 a. In addition, othermechanical devices, such as cross-bars and/or levers could be used toincrease the diameters d_(a1) and d_(a2) of the expandable proximalreamer 30 a.

Turning now to FIGS. 5 and 5 a, an alternative embodiment of a pilotshaft 50 is shown. As discussed above, a pilot shaft is attached to theproximal reamer to ensure that the reamer properly extends downwardlyinto the canal. Also as discussed above, because the distal reamer 8 maycome in various sizes, the pilot shaft must also come in a variety ofsizes. Therefore, to cut-down on manufacturing costs and to reduce thepossibility of confusion in the operating, in one embodiment of thepresent invention, the pilot shaft 50 is also adjustable. As shown inFIG. 5, the pilot shaft 50 includes a proximal portion 52, a distalportion 54 and a central portion 56. The central portion 56 includes asleeve 58 that engages two threaded screws 60, 62. As the sleeve 58 isrotated, the threaded screws 60, 62 are pushed into openings 64, 66 inthe proximal and distal portions 52, 54. The proximal and distalportions 52, 54 each include slits 68, 70 that open as the threadedscrews 60, 62 are pushed into the openings 64, 66 (as shown in FIG. 5b).Thus, the operator is able to adjust the diameter of the pilot shaft 50to match the diameter of the reamed canal 10. In the embodimentsillustrated in FIGS. 5 and 5 a, the pilot shaft 50 is adjusted fromhaving a diameter of D_(c) to D_(d). As shown in FIGS. 5 and 5 a, thepilot shaft 50 also includes a connectable mechanism such as a threadedportion 72 for attachment to the expandable proximal reamer 30 a.Alternatively, the threaded portion 72 may also attach to a miller shellor a proximal body trial (not shown).

Turning now to FIG. 6, an alternative embodiment of an expandableproximal reamer 80 is illustrated. In this embodiment, the expandableproximal reamer 80 includes an upper conical recess 82. A threadedexpansion rod 84 has a threaded end 86 and is inserted into the upperconical recess 82. As the threaded expansion rod 84 is advanced throughthe upper conical recess 82, the expandable reamer 80 is widened throughthe use of a slit 88. The user may thus adjust the diameters of theexpandable reamer 80.

As shown in FIG. 6, the threaded expansion rod 84 may include a gauge90, allowing the user to determine the diameter of the reamer 80. Also,the rod 84 may include upper and lower support rods 92, 94 that extendinto the reamer 80 to keep the reamer 80 and the rod 84 rigid duringuse. Either or both of the support rods may also be used in connectionwith any of the embodiments discussed above.

In all of the embodiments discussed above, whether for distal reamers,proximal reamers, or pilot shafts, the various gauges and/or markingsmay also include preset stops that correspond to certain sizes. Suchpreset stops would make it easier for a user to accurately stopadjusting at the correct diameter. The preset stops may be fashioned outof notches in a thread or any other known mechanism.

Turning now to FIG. 7, another embodiment of an expandable proximalreamer 100 is illustrated. In this embodiment, the proximal reamer 100includes a screw 102 that extends outwardly from the proximal reamer100. The screw 102 has a threaded portion 104 a that is threadablyengaged with threaded portions 104 b, 104 c of supports 105. Thesupports 105 provide the reamer 100 with support during cutting,enabling the reamer 100 to expand, yet still maintain its strength andrigidity.

As a user rotates the screw 102, the threads 104 a cause the threadedportions 140 b, 104 c to also rotate. The threaded portions 104 b, 104 care also threadably engaged with a thread 104 d, such that when thethreaded portions 104 b, 104 c are rotated, the threaded portion 104 dalso rotates. The threaded portion 104 d is coupled to a cone 106, suchthat as the threaded portion 104 d rotates, the cone 106 moves in adownward direction 112 (FIG. 7 a), causing the proximal reamer 100 toexpand outwardly in the direction indicated by arrows 114. This alsocauses the supports 105 to move outwardly in directions 110 as shown inFIG. 7 a.

As shown in FIGS. 7 and 7 a, the proximal reamer 100 is coupled to apilot shaft 108, such that as the cone 106 moves downwardly, the pilotshaft 108 may also expand in an outward direction as indicated by arrows114 (FIG. 7 a).

Turning now to FIG. 8, a method for utilizing the expandable reamers isshown. At step s200, the femur is resected. Next, the user selects thedistal reamer to be used at step s202. If an expandable distal reamer isto be used, then at step s202, the user then adjusts the diameter of thedistal reamer as described above. At step s204, the distal reamer isinserted and the distal portion of the long bone is reamed (step s206).Next, at step s208, the proximal reamer is selected. If the proximalreamer is an adjustable reamer, the user will adjust the proximal reamerto the appropriate diameter. If the proximal reamer is not adjustable,then the user must select a proximal reamer with an appropriate diameterfrom a set of reamers. Next, at step s210, the pilot shaft is selectedor adjusted as necessary. At steps 212, the proximal reamer is attachedto a pilot shaft. The proximal reamer and shaft are inserted into theproximal portion of the long bone and the reamed distal portion,respectively at step 214. The proximal portion is then reamed at steps216. The rest of the reaming and implantation process is then completedin any of the ways customary and known in the prior art. It should benoted that although in this example, both the proximal reamer and thedistal reamer were expandable, that in some embodiments, only one of thereamers may be expandable. Also, while some embodiments refer to anadjustable pilot shaft, in other embodiments, the pilot shafts of theprior art may be attached to the proximal reamers.

In some embodiments of the present invention, a kit for reaming the longbone is provided, including distal reamers, proximal reamers, and pilotshafts. The kit includes at least one reamer that is an expandablereamer. In some embodiments, both the distal reamer and the proximalreamers will be expandable. In other embodiments, only one of the typesof reamer will be expandable. In some embodiments, the pilot shaft mayalso be expandable.

According to some embodiments of the present invention, the expandablereamers may be able to expand to all sizes required for that type ofreamer. In other embodiments, the expandable reamers may only expandthrough a range, and a plurality of reamers may still be required. Forexample, if the expandable reamer is a proximal reamer, a kit mayinclude three expandable proximal reamers. Each expandable proximalreamer in such a kit has a diameter that is variable within a range.

Although the present invention and its advantages have been described indetail, it should be understood that various changes, substitutions, andalterations can be made therein without departing from the spirit andscope of the present invention as defined by the appended claims.

1. A reamer for reaming a portion of a long bone cavity for use inimplanting a joint prosthesis, the reamer for cooperation with a portionof an orthopaedic implant component, the reamer comprising: anexpandable body, the expandable body adapted to adjust between aplurality of diameters; and a plurality of cutting edges extendingoutwardly from the body, the edges adapted for cooperation with bone,the cutting edges expanding as the expandable body expands.
 2. Thereamer of claim 1, wherein the body comprises at least one gear, the atleast one gear for adjusting the diameter of the reamer.
 3. The reamerof claim 2, further comprising a gauge coupled to the at least one gearfor rotating the gear.
 4. The reamer of claim 1, wherein the body iscone-shaped including a proximal region and a distal region.
 5. Thereamer of claim 4, wherein the diameter of the proximal region of thereamer is expanded more relative to the distal region.
 6. The reamer ofclaim 1, wherein the body includes longitudinal channels, such that thelongitudinal channels enlarge when the body is expanded.
 7. The reamerof claim 1, wherein the reamer is one of a cylindrical reamer adapted toream a cylindrical portion of a long bone and a conical reamer adaptedto ream a conical portion of a long bone.
 8. The reamer of claim 1,wherein the body further includes at least one of a mechanical system, ahydraulic system, or a pneumatic system to expand the body.
 9. A methodfor reaming a portion of a long bone cavity for use in implanting ajoint prosthesis, the reamer for cooperation with a portion of anorthopaedic implant component, the method comprising; reaming acylindrical portion of the long bone using a cylindrical reamer; andreaming a conical portion of the long bone using a conical reamer;wherein at least one of the cylindrical reamer and conical reamer is anexpandable reamer, such that the at least one of the cylindrical reamerand conical reamer includes an expandable body adapted to adjust betweena plurality of diameters.
 10. The method of claim 9, further comprisinginserting a gauge into the cylindrical reamer to adjust the diameter ofthe cylindrical reamer.
 11. The method of claim 9, further comprisingattaching a pilot shaft to the conical reamer, the pilot shaft beingexpandable.
 12. The method of claim 11, wherein the pilot shaft includesa sleeve and a pair of threaded screws coupled to the sleeve, the methodincluding increasing the diameter of the pilot shaft by rotating thesleeve and causing the threaded screws to extend into the expandablebody.
 13. The method of claim 9, wherein the conical reamer includes adistal region and a proximal region and the diameter of the conicalregion is expanded more relative to the distal region.
 14. The method ofclaim 9, wherein the conical reamer is a proximal reamer and thecylindrical reamer is a distal reamer.
 15. A kit for reaming a portionof a long bone cavity for use in implanting a joint prosthesis, thereamers for cooperation with portions of an orthopaedic implantcomponent, the kit comprising: a distal reamer for reaming a distalportion of the long bone; a proximal reamer for reaming a proximalportion of the long bone; and a pilot shaft for insertion into a reameddistal portion and attachment to the proximal reamer during the reamingof the proximal portion; wherein at least one of the distal reamer,proximal reamer, and pilot shaft is expandable, such that the at leastone of the distal reamer, proximal reamer, and pilot shaft includes anexpandable body adapted to adjust between a plurality of diameters. 16.The kit of claim 15, wherein the expandable body comprises at least onegear, the at least one gear for adjusting the diameter of the reamer.17. The kit of claim 16, further comprising at least one of a gauge anda threaded expansion rod coupled to the at least one gear for rotatingthe gear.
 18. The kit of claim 15, wherein the expandable body iscone-shaped including a proximal region and a distal region and thediameter of the proximal region of the reamer is expanded more relativeto the distal region.
 19. The kit of claim 15, wherein the expandablebody includes longitudinal channels, such that the longitudinal channelsenlarge when the expandable body is expanded.
 20. The kit of claim 15,wherein the expandable body includes an outer sleeve coupled to a pairof threaded screws, such that when the sleeve is rotated, the threadedscrews extend into the expandable body, increasing the diameter of thepilot shaft.